Health care leaders: CON program needed

COLUMBIA — With South Carolina’s hospital expansion regulations pulled, health care leaders in Georgia and South Carolina are wary of the new facilities frontier.

The Bluffton-area landscape may escape any immediate impacts but could feel the effects in the future. Among the broader concerns: Whether low-income and uninsured patients will have practical access to a health care facility.

Paul Hinchey, president and CEO of St. Joseph’s/Candler in Savannah, said the health system “strongly supports” the certificate of need process.

“Although St. Joseph’s/Candler currently does not have any pending CON applications, this decision could impact how we invest in services in the future,” he said. “We are hopeful a solution will be found.”

The S.C. House had sustained Gov. Nikki Haley’s veto of $1.7 million to operate the CON program, which the S.C. Policy Council, a free-market think tank, has called “a pernicious barrier to health care freedom.”

Under a heading, “Closing Programs that Don’t Work,” the governor wrote in her veto message that the CON program “is an intensely political one through which bureaucratic policymakers deny new healthcare providers from offering treatment.”

The Republican governor had also vetoed the funding last year, but in that case, both the House and Senate overrode her decision.

S.C. Department of Health and Environmental Control director Catherine Templeton released a letter at the end of June announcing her agency would freeze the program for the fiscal year that began July 1.

“Suspending the program has the practical effect of allowing new and expanding health care facilities to move forward without the certificate of need process,” wrote Templeton.

Under CON regulations, which are implemented in Georgia, North Carolina, and most other states, a hospital argues its case for a CON permit, in order to expand its facility, build a new one, or install major equipment.

Far from freeing up expansions, the S.C. Hospital Association, which supports the certificate of need structure, said Haley’s veto “paralyzed” the market.

“Unfortunately for South Carolina’s economy, nearly $100 million in health care related improvement projects are now indefinitely on hold — along with the jobs and revenue they bring,” said Executive Vice President Allan Stalvey, in a statement.

Hinchey also made the case for the regulatory process: “CON helps keep hospitals viable in their communities, restricts the overbuilding of costly medical services and ensures services are located appropriately so that everyone has access to affordable medical care. But most importantly, CON laws have a positive impact on quality by preventing the over saturation of a service, which dilutes experience.”

Part of the intent, said Kevin Bloye, spokesman for the Georgia Hospital Association, is to make sure health care facilities that serve uninsured and Medicaid patients are able to stay open by also caring for patients who can afford to pay.

“It controls health care costs and protects those facilities who are providing millions and millions of dollars in uncompensated care (from) going out of business, (due to) other providers coming in without a CON and cherry picking the best patients, those people you can actually pay for services,” he said.

Who wins?

If nothing is done, said Bloye, South Carolina hospitals will have an edge over those just over the border in Georgia.

“Will health care facilities in South Carolina be given a free pass to build and expand without a CON? If ultimately that happens, and it remains to be seen exactly what will happen, yes, it will certainly have an impact on those Georgia hospitals near border cities in South Carolina,” said the Georgia Hospital Association official.

“Those are the hospitals they compete with. It would create an uneven playing field, for certain,” he added.

Last year St. Joseph’s/Candler and Hilton Head Hospital reached an agreement to settle a years-long competitive dispute over DHEC’s decision to grant Hilton Head Hospital a CON to construct a Bluffton Outpatient Center. The Georgia system had warned the facility proposed by its rival could only meet patient volume projections by shifting patients from its nearby facility.

North Carolina has also been monitoring the events in South Carolina.

“It’s a situation we are paying pretty close attention to,” said Don Dalton, of the North Carolina Hospital Association.

“We feel like CON is very important planning tool, we are fortunate in North Carolina to have a strong CON program and hope to maintain ours here.”

Whether the suspension ushers in a hospital free-for-all may be decided in court. The state health agency has asked the S.C. Supreme Court to determine whether the program must be continued.

“We are glad that DHEC has asked the court to rule on the issue,” said Beaufort Memorial Hospital President and CEO Rick Toomey.

“The CON law remains, and we believe that veto of funding is not in the best interest of the state. While the law is not without some flaws, efforts over the past year to streamline the process would address some of the concerns,” Toomey said.

Bluffton’s CON king

What about a mammoth, $90 million-plus facility planned for Bluffton? The future Pace Healthcare Commons is slated for a spot with south frontage on Bluffton Parkway, half a mile from the west termination at S.C. 170.

Pace CEO Brian Cain said the post-acute geriatric facility is undeterred by South Carolina’s suspension of the CON program. The project, which received extensions on its CONs because of delays connected to financing hurdles, received what some have called a nationally unprecedented four CONs from South Carolina regulators.

The executive said he has not yet closed on the land, which is owned by Reed Development, and a possible partnership with Beaufort Memorial Hospital remains “on the table.”

“We’re moving forward as planned,” said Cain. “We intend to bring the project online as soon as possible.”

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That is why N.C has over 400,000 illegals there and we have 82,000, while Georgia has over 300,000 while illegals anchor babies still drain taxpayers.

In the hours leading up to the administration's surprise decision Tuesday to delay implementation of Obamacare, the president's team gave no indication of the course reversal, in a way hiding it by spending $32 million on children's health care and announcing plans to expand the PR campaign.

One example: three and a half hours before notifying the public of the change in a Treasury Department blog post, Health and Human Services Secretary Kathleen Sebelius held a conference call with reporters to announce a $32 million spending program to enroll poor and immigrant kids into the Children's Health Insurance Program.

"Every child in America should have access to the quality health care that they need," she said, giving no hint that Obamacare, which supplied the $32 million, was about to be sidelined.

What's more, she talked about how Obamacare's insurance exchanges were going to kick in on time "this fall."

Also on the call was top Medicare and Medicaid official Cindy Mann who, when asked about the National Football League deciding against helping in the Obamacare public relations effort, said that the administration still "reaching out" to other groups to help get Americans to sign up for the mandatory health insurance program.

Take away the magnets for illegals and they won't come here. Our own VIM is inundated with illegals. I took a friend there who is homeless and she could not be seen for at least a month. It was the same at the Genesis Center.

DHEC in S.C should be under scrutiny for waiting two weeks to investigate and or quarantine a school in Greenwood S.C for having a employee that spread TB throughout the school and the community. They need to be held accountable.

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